HPV self-sampling acceptability among women in Italy: preliminary results of a cross-sectional study

Abstract Background Secondary prevention measures have strongly contributed to the reduction of incidence and mortality of cervical cancer (CC) identifying women at high risk of developing it. This cross-sectional study aimed to investigate the acceptability of a home-based self-sampling methodology for Human Papilloma Virus (HPV) testing and the factors that may influence women’s preference. Methods A random sample of women over the age of 50 years has been selected in Southern part of Italy. Data was collected through an anonymous self-administered questionnaire and included socio-demographic characteristics, knowledge of HPV infection and prevention measures, and attitudes towards the acceptability of self-collected cervico-vaginal sampling (CVS) and urine sampling (US). Results Among the 321 women who completed the survey, more than two-thirds (73.7%) knew that CC is caused by HPV, only 68.9% knew that the HPV screening is useful for an early detection and diagnosis of CC, and 17% never had Pap-test or HPV-DNA test. Of the respondents, 67.9% declared that they preferred self-collected US for future HPV testing compared with clinician-taken cervical samples (CCS). The most common reasons reported for preferring US included that it was easier (54.8%), more convenient (28.7%), and less embarrassing (21.7%). Among those women who showed negative attitude towards self-collected US, 8 out of 10 (77.3%) expressed scepticism about its diagnostic performance. Only 37% of the sample preferred CVS, and this attitude is mainly attributable to the fear of not carrying out a correct self-sampling (71.2%) and to its underrated diagnostic performance (33.7%). Conclusions The preliminary results suggest that US is more acceptable than CCS and CVS in Italy. Urinary HPV test presents similar accuracy of the latter tests to detect CC and its supply in the context of population-based screening programmes could improve adherence, reducing the cost and burden on physicians. Key messages • Urine self-sampling could represent an innovative early detection approach to increase adherence to cervical cancer screening programmes. • Further research is needed to assess whether the screening status and the strategy of self-samplers distribution could act as predictors of screening uptake.


Background:
Secondary prevention measures have strongly contributed to the reduction of incidence and mortality of cervical cancer (CC) identifying women at high risk of developing it. This cross-sectional study aimed to investigate the acceptability of a home-based self-sampling methodology for Human Papilloma Virus (HPV) testing and the factors that may influence women's preference.

Methods:
A random sample of women over the age of 50 years has been selected in Southern part of Italy. Data was collected through an anonymous self-administered questionnaire and included socio-demographic characteristics, knowledge of HPV infection and prevention measures, and attitudes towards the acceptability of self-collected cervico-vaginal sampling (CVS) and urine sampling (US).

Results:
Among the 321 women who completed the survey, more than two-thirds (73.7%) knew that CC is caused by HPV, only 68.9% knew that the HPV screening is useful for an early detection and diagnosis of CC, and 17% never had Pap-test or HPV-DNA test. Of the respondents, 67.9% declared that they preferred self-collected US for future HPV testing compared with clinician-taken cervical samples (CCS). The most common reasons reported for preferring US included that it was easier (54.8%), more convenient (28.7%), and less embarrassing (21.7%). Among those women who showed negative attitude towards self-collected US, 8 out of 10 (77.3%) expressed scepticism about its diagnostic performance. Only 37% of the sample preferred CVS, and this attitude is mainly attributable to the fear of not carrying out a correct selfsampling (71.2%) and to its underrated diagnostic performance (33.7%).

Conclusions:
The preliminary results suggest that US is more acceptable than CCS and CVS in Italy. Urinary HPV test presents similar accuracy of the latter tests to detect CC and its supply in the context of population-based screening programmes could improve adherence, reducing the cost and burden on physicians.
Key messages: Urine self-sampling could represent an innovative early detection approach to increase adherence to cervical cancer screening programmes. Further research is needed to assess whether the screening status and the strategy of self-samplers distribution could act as predictors of screening uptake.

Background:
Appropriate dissemination of public health evidence is of high importance to ensure that relevant knowledge reaches potential stakeholders and relevant population groups. A wide distrust towards science and its findings indicates that communication thereof remains below its potential. Cochrane Public Health (CPH) provides an important source of highquality scientific evidence. This study aimed to identify (1) dissemination strategies and (2) possible stakeholders of Cochrane Public Health reviews.
Methods: This is a cross-sectional, meta-research study. All 68 records (reviews or protocols) listed on the CPH website https:// ph.cochrane.org/cph-reviews-and-topics up to 08.03.2022 were included. Record characteristics, dissemination strategy information and potential stakeholder details were coded by one author and 10% of records were checked by another author. Data were descriptively analysed. Results: 53 reviews (46 systematic reviews, 6 rapid reviews, 1 scoping review) and 15 review protocols were included. The 53 reviews were published between 2010-2022 and included 1-153 primary studies. All reviews had an open-access plain language summary (PLS) in English with translations in 3-13 other languages. Although 16 of 53 reviews and 4 of 15 protocols reported any involvement in the review process of an advisory group, only 3 of 68 records included a dissemination plan aiming to inform non-academic audiences or policy.

Conclusions:
All identified records can be considered as relevant to a wide range of stakeholders and population groups. However, CPH reviews or protocols rarely report their dissemination strategies. It is unclear what dissemination strategies are used after CPH reviews are published. High relevance of CPH evidence for non-academic stakeholders and the general population highlights the need for adequate knowledge translation beyond academia.
Key messages: Dissemination plans and implementation is rarely reported in CPH reviews. Evidence from CPH reviews is relevant for a multitude of stakeholders.